Rus Articles Journal

Easy as a pie? Food of children at a lack of weight

the Organism of small children is characterized by high growth rates and developments, but at the same time has low reserve potential. Therefore the problem of low weight at kids till 3 years arises more often than in other age groups. Of course, malovesny children need special food.

About insufficiency of food are told in the presence at the child of deficit of body weight of 10% and more from individual norm. Let`s remind that the healthy kid on the first month of life adds on average 600 g. Then, to six-months age, boys add on average 800 g, and girls - on 700 g a month. In the second half of the year of life the increase of body weight has to make 400 g a month. By 1 year the weight of the “average“ child makes 10 - 10,5 kg. On the second year of life the kid has to recover on 3 kg. The approximate body weight of children at the age of 2 - 11 years can be calculated on a formula 10,5+2p where p - age of the child till 11 years, 10,5 - the average mass of the one-year-old kid. If at approximate calculation at the kid deficiency of body weight comes to light, the problem needs to be considered in more detail and surely - with participation of the pediatrician who observes the child.

Why deficiency of body weight arises?

several options of an assessment of a condition of the child having deficiency of body weight Exist. Let`s consider briefly everyone.

the Hypotrophy - the chronic disorder of food which is characterized by development of exhaustion, a metabolic disorder and decrease in resilience of an organism. At a hypotrophy, as a rule, growth of the kid meets age standards, but decrease in fatness of the child takes place. The adverse course of pregnancy at mother, congenital malformations zheludochno - an intestinal path, hereditary anomalies of a metabolism, immunodeficiency, endocrine diseases, the postponed infections, etc. can be the reasons of a hypotrophy. In case of absence of serious diseases, as a rule, errors in food of the baby are the reasons of a hypotrophy:

  1. Quantitative underfeeding. Such situation is possible at insufficient amount of breast milk at mother; at difficulty of feeding if the flat, pulled-in nipple takes place, a “hard“ mammary gland, especially in case of restriction of duration of feedings and in attempt of feeding of the kid strictly on the mode, with observance 3 - hour intervals between feedings at children of the first months of life. Difficulties of feeding can arise also if the kid has a short bridle of language, a small lower jaw. The frequent and plentiful vomiting which is a consequence of neurologic violations is the reason that the children`s organism does not receive milk in sufficient volume too.
  2. Qualitative underfeeding. Its reasons become feeding the mixes which are not corresponding to age; too late introduction of feedings up; irrational food at which deficiency of proteins, fats, carbohydrates, mineral substances, vitamins or minerals takes place.
Than hypotrophy degree is higher than

, especially metabolic disorders in an organism of the child are expressed and the ability to digestion of nutrients, first of all is lower than proteins, in intestines. The lack of nutrients, vitamins and minerals is negatively reflected in work of internals. Quickly enough the condition of skin of the baby worsens. If healthy children have a clean skin, pink and velvety to the touch, then at patients with a hypotrophy dryness and a peeling of skin, decrease in its elasticity take place, in hard cases skin becomes flabby and has a grayish shade. Children with a hypotrophy have infectious diseases more often and heavier. In the absence of treatment the delay of mental and physical development of the baby can begin.


- chronic disorder of food with more or less uniform lag of the child both in body weight, and in growth. At the same time fatness of the baby can be quite satisfactory. Of a gipostatura it is characteristic that the child on the physical and psychomotor development lags behind peers. Gipostatura is, as a rule, typical for children with congenital heart diseases, heavy encephalopathy - mi (defeats of the central nervous system which emergence is connected with the conditions which are adversely developing for a fruit during its pre-natal development and at the time of delivery), endocrine violations, some hereditary diseases. After elimination of the reason of a gipostatura if it is possible, children catch up on physical development of the peers.

the Growth inhibition of constitutional character is diagnosed by the doctor in cases when, except lag on growth - to weight indicators, other deviations and any diseases at the child it is not revealed. These children most often are born at undersized thin parents.

Though such child differs from peers in the low growth and small body weight, it is difficult in proportion, has the normal thickness of a podkozhnozhirovy layer, is almost healthy and normally develops in the physical and mental plan. Sometimes such children during puberty begin to grow violently and catch up with the peers on the weight and growth. Usually children with hereditarily the caused “leanness“ eat less, than it is necessary on age. This fact quite often causes alarm in parents. However practice of violent feedings can lead to a bigger loss of appetite or even to digestion violations, and then there can be a true violation of food, develop a hypotrophy. Therefore the diet in this case has to correspond to the level of physical development of the child (his growth and body weight). The food of the kid should not be overloaded with either proteins, or fats, or carbohydrates. All nutrients have to be in the balanced ratio, according to this age.

in the presence at the child of deficiency of body weight the attending physician appoints by

complex inspection and treatment which includes:

in the absence of a serious illness or malformations of an organism of the child a basis of rational treatment is made by a dietotherapy.

Criteria of efficiency of dietary treatment:

  • improvement of the emotional status (the kid becomes more active, it has a good mood, it is vigorous and inquisitive);
  • appetite normalization;
  • improvement of a condition of skin (it is estimated by the doctor);
  • acquisition of new skills of psychomotor development;
  • daily increase in body weight;
  • improvement of digestion of food (according to a koprogramma).
in case of signs of decrease in tolerance of foodstuff food volume is temporarily reduced. It should be noted that the individual approach to a diet and rates of its expansion is necessary for each child.

the General principles of food

Important points of a dietotherapy at a hypotrophy consist in the following:

  1. at the initial stage of treatment to the child are given only digestible food (for children aged till 1 year - breast milk or the adapted mixes). Use more often the nizkolaktozny adapted mixes as they are digested easier and are better acquired);
  2. the frequency of feedings increases (for the child of the first half of the year which is on artificial feeding, at deficiency of body weight from 11 to 20% food has to be seven-single, at deficiency of 21 - 30% - eight-single if deficiency of body weight makes more than 30%, the child is fed by 10 times a day with small volumes, when breastfeeding it is necessary to adhere to the mode of feedings “on demand“ if at the child appetite is kept. However, at a hypotrophy appetite usually sharply decreases, the child eats seldom and few. Therefore the kid is fed at least, than it is necessary at this degree of a hypotrophy. If the child is nursed, control weighings are necessary for definition of amount of the exhausted milk per day. If the kid owing to a state of health cannot exhaust the put milk volume from a breast, it needs to be finished feeding the decanted milk);
  3. by
  4. exercises systematic control of food - maintaining the diary in which the quantity of the food eaten in each feeding, the volume of the drunk liquid, frequency and character of a chair, number of urinations is noted per day. These data will be necessary for the attending physician for the correct calculation of food loading and an assessment of extent of assimilation of food.

At observance of rules of medical foods and doctor`s instructions removal of the child from a hypotrophy of easy degree happens within 1 month, medium-weight - within 2 - 3 months, heavy - till 4 - 5 months.

As the children having deficiency of body weight more than 20% (a hypotrophy of II and III degrees) for inspection and treatment usually go to a hospital, we will consider the principles of medical foods of children with deficiency of weight no more than 20%.

the Hypotrophy and the wrong care of the child Should note

that among the reasons promoting development of a hypotrophy, also defects of care of the baby are of great importance: deficiency of attention and caress, psychogenic stimulation (emotionally painted speech, lullabies, reading fairy tales, verses, etc. belong to such stimulation) lack of daily walks in the fresh air, water procedures, etc.

From the birth till 6 months

For the babies who are not receiving feedings up optimum is feeding breast milk. It is necessary to eliminate the factors interfering normal sucking of milk from a breast: at “a hard breast“ - massage of gland and a warm shower before feeding of the child, at the flat, pulled-in nipple - use of special slips during feeding. If the kid owing to a condition of the health cannot exhaust amount of milk necessary for it, it is necessary to finish feeding it the decanted milk, it is desirable from a spoon.

to the Kid who is on breastfeeding needs to provide to

the mode of feedings on demand, including in night and hours at dawn, to exclude restriction of stay at a breast on time.

Is recommended to carry out control weighings of the child when feeding by a breast for the purpose of definition of exact amount of the exhausted milk. The technique of control weighings means determination of body weight of the child before each chest feeding and after it within a day. Define how many milk exhausted from a breast the baby for each feeding, then put these data and receive the daily volume of food. The received result is compared to that which corresponds normal in this case (the volume of food is counted not only proceeding from age norms, but also depending on body weight at the birth and the weight of the kid at the time of survey). Pay attention that single weighing before feeding and after it does not give objective data as the amount of the milk received by the child during feedings can differ significantly within a day.

If mother has a gipogalaktiya (insufficient development of breast milk), the pediatrician appoints dokorm in the form of the adapted dairy mix. To the children who are on artificial feeding with the assistance of the pediatrician the adapted dairy mix which corresponds to age and features of an organism of the kid is selected, does not cause an allergy and signs of intolerance (vomiting, an abdominal distension and gripes, violation of a chair).

At the initial stage of dietary treatment which at a hypotrophy of easy degree proceeds 1 - 2 day the pediatrician appoints by

to the child the volume of mix or breast milk equal 2/3 because of the volume which corresponds to the actual body weight of the child. The missing part of volume of food is filled surely with liquid in the form of physiological solution, by Regidrona, Oralita, etc. (what solution and in what volume to apply - the doctor solves). These solutions are called also “regidratsionny“, that is filling missing volume liquids. Except water they contain mineral salts in the structure that is necessary for the “correct“ use of liquid body tissues.

If the kid at such approach well acquires food (i.e. it has no loss of appetite, an unstable chair, signs of violation of digestion of food in the analysis a calla - a koprogramma: the increased amount of neutral fat, fatty acids, soaps), by the end of the second day the volume of food is led up to forced on the actual body weight. Further continue gradual increase in amount of mix, seeking to reach the daily volume of the food calculated on the body weight which the child would have to have at this age (the must body weight). This period is called transitional.

After safe end of a transition period the period of the strengthened food begins

. The child receives approximately the same volume of mix as his healthy peers who do not have a hypotrophy. The pediatrician observing the kid can recommend earlier introduction to a diet of the baby of a feeding up. As a rule, the first feeding up of malovesny children is porridge (it is more preferable instantny porridges - the soluble porridges which are let out especially for feeding of children not demanding cooking) as its taste usually is pleasant to kids, it is easily acquired, provides an organism with enough energy. In this case it is allowed and even cultivation of nonmilk porridge is recommended by dairy mix or the decanted breast milk.

From 6 months to 1 year

For children 6 months within 1 - 2 days are aged more senior than

exclude all feedings up and pass to feeding with mixes (optimum - breast milk). Mix volume also has to make 2/3 from due on the actual body weight. Respectively, 1/3 daily volume of food fill at the expense of the reparation solutions which are listed above. During a transition period continue gradual increase in volume of mix, watching a condition of the child, under control of a koprogramma (the test a calla is made daily). At the same time seek to reach the volume of the food calculated on the weight which the child would have to have at the moment. Then gradually reduce the number of feedings and start consecutive introduction of the feedings up put on age.

From 1 year to 3 years

Aged from 1 year till 3 years the dietotherapy also consists of three stages: the initial stage of clarification of tolerance of various foodstuff, a transition period and a stage of the strengthened food. Unlike children of chest age, at the first stage usually there is no need for full cancellation of all dishes of a feeding up and transfer to feeding by exclusively dairy mixes. Nevertheless, some “rejuvenation“ of a diet takes place. Offer the kid instantny porridges from one type of grain, vegetable and fruit purees, veal, dairy drinks, cottage cheese, egg. Exclude products hard to digest, for example fat meat, whole cow`s milk (it is replaced with mix); seafood, exotic fruit. One third of daily volume of food (at a slight hypotrophy) is covered at the expense of regidratsionny solutions as which for children 1 years are more senior it is possible to use also vegetable broth, compote from dried fruits. During the transition period the child`s diet is gradually expanded, reduce extent of crushing of products. At a stage of the strengthened food the kid receives the food calculated on the body weight which would have to take place at the child at this age. Parents have to pay much attention to observance of a day regimen and food, to resort to the receptions helping to improve appetite of the baby.